Drainage of a infected pressure ulcer on the toe (PART 1)

This was a good teaching case. The resident had seen this patient first and, with his foot flat against the ground, diagnosed him with cellulitis. However, closer inspection revealed a pressure ulcer underneath and if that is at all fluctuant, it likely has pus inside, as this one did. You have to debride these areas or they will never heal. Antibiotics alone will be insufficient. There was no local anaesthetic used during this procedure and typically you won't need any. The tissues are under such pressure and usually macerated for so long that removing the dead tissue is not uncomfortable, as was the case here. This was simply a result of a long term pressure ulcer that hadn't been dealt with properly. In PART 2 I will follow this wound over the next few weeks and hopefully we can heal this more completely.